The Health Wrap: the Ebola crisis deepens; poverty; rethinking health

By Frances Gilham

The Ebola crisis deepens

A dangerous new chapter has begun in the deadly Ebola epidemic, as crowds of people clashed with law enforcers trying to maintain quarantine zones to halt the disease spread in Liberia, the New York Times reported.

Without a cure or vaccine for the disease, the World Health Organization has endorsed the offering of experimental drugs to people infected with the virus, but with limited supplies available, many wondered who should be receiving priority treatment, the ABC said.

In this interview with Vox, a clinical ethicist explained why using unproven Ebola medicine is bad science, as well as ethically dubious. Another US-based article examined how the solution may lie in commonly used medicines already proven to be safe.

And the New Yorker reported on the hopeless economics of finding a cure for Ebola, suggesting that offering a prize might be the best way to encourage pharmaceutical innovation in this area.

The outbreak is a disaster of poverty, The Star said in a moving article.

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Poverty, geography and health

Poverty is a recurrent theme in health, and this article provided a sobering insight into the organ trafficking trade, demonstrating how poor people are selling their organs to save lives on the black market.

In this blog post on the American Public Health Association’s Public health newswire, a public health researcher wrote about his research that showed raising the US minimum wage from $9 to $13 would boost income for 7.5 million lower-income people and prevent at least 389 premature deaths per year.

And in this article for The Conversation, ANU academic Sharon Friel wrote about climate change, and how its health effects will be felt most severely by poorer households and neighbourhoods. Marie McInerney also provided a great wrap on this topic for Croakey.

Geography can affect health in other ways, too. Australians living in regional areas are much more likely to suffer from cardiovascular disease, a new study from the Heart Foundation found.

And a series of articles in The Atlantic highlighted the importance of street design and neighbourhood cohesiveness, and how they relate to health in surprising ways.

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Depression and drugs

Actor Robin Williams’ recent death was a sad shock to many and resulted in a multitude of news articles, opinion pieces and blog posts.

Sebastian Rosenberg from the University of Sydney’s Brain & Mind Research Institute wrote a particularly thought-provoking article in the SMH exploring the confusion surrounding how we talk about suicide in the media.

“We owe it to the thousands of bereaved families across Australia to finally take suicide seriously as a public health issue,” he wrote.

Australian psychiatrist and researcher Professor Louise Newman wrote an open letter to the Government, linked from Croakey, accusing them of ignoring the harmful effects of mandatory detention for children, which she says contributes to significant mental deterioration.

And a group of researchers from the University of New South Wales wrote about the perfect storm of alcohol, drugs and depression for The Conversation.

On the topic of drugs, many are watching the legalisation of marijuana in Colorado in the US with interest, to see how the policy plays out amid the ‘war on drugs’ elsewhere. For this long read in The Atlantic, a journalist visited Boulder, Colorado, and spoke with residents about life after legalisation.

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Rethinking health

With the co-payment – and future of our primary healthcare system – still under consideration, many groups are worried about the influence the Australian Medical Association is having on the outcome.

Alternative ideas continued to emerge in the media, with Margaret Faux arguing on Croakey that we already have co-payments that we can make better use of, by tweaking the way we pay for post-operative treatment.

John Dwyer, Emeritus Professor of Medicine at UNSW, wrote a blog post detailing the model of primary care he believes we need in contemporary Australia – based on an integrated, patient-focused system.

Stephen Duckett contributed this article on The Conversation with his tips for a sustainable and quality system.

And an interesting read from The Guardian explains why the author thinks the UK’s National Health Service is brilliant – and why Australians should beware changes to Medicare.

Going down the route of a US-style system may not be an ideal solution, if this article written by a US journalist for Forbes is anything to go by. He compared his experience in the healthcare system to his cat’s experience at the local vet, and it wasn’t favourable.

“After 14 years of writing about medicine, in a relatively minor encounter with the medical system, I’d felt only a bit more in control than a tiny, scared cat curled up against my chest,” he wrote.

Another proposal by the Government would see a potential change of management of Medicare and PBS claims and payment processing. This Croakey blog post collates views from a variety of experts on the issue, and considers what the implications might be, in particular for linked data research.

For his latest Wonky Health column, Dr Tim Senior reviewed Rob Oakeshott’s book – and said more can be gleaned from what isn’t in there than what is, including much of an examination of what causes inequalities in Australia. Rob Oakeshott’s thoughtful response is definitely worth a read, too.

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Indigenous policy: inequity and excellence

The co-payment has also been critiqued from within the Indigenous community, with 26 Indigenous health services across the Northern Territory confirming they will not be charging the co-payment in any of their clinics, according to an ABC article.

“The impact of this payment will actually widen the health gap between Aboriginal and non-Aboriginal people,” chief executive of the Aboriginal Medical Services Alliance of the NT John Paterson was quoted as saying.

To overcome health inequities between Indigenous and non-Indigenous peoples in Australia and New Zealand, health professionals and their institutions need to take a long, hard look at themselves and their biases, according to public health physician Dr Rhys Jones in this blog post published on Croakey.

And the latest column from ‘The Koori Woman’ on Croakey examines these biases from a personal perspective.

This article on the SBS news website examined Indigenous policies shaped and driven by Noel Pearson, and said they weren’t based on good evidence or an efficient use of taxpayers’ money.

But there is much good work to celebrate within the sector, with an Indigenous governance award drawing a record number of entrants, with health, drug and alcohol rehabilitation, and land and sea management groups among eight finalists for a $20 000 prize offered by Reconciliation Australia in partnership with BHP Billiton, to identify, celebrate and promote strong Indigenous governance, The Guardian reported.

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Research news

Senator Eric Abetz found himself in a media scandal when he quoted research that linked breast cancer to abortion.

With many saying this wasn’t based on evidence, a Croakey post said this may have just been a symptom of the Government’s general disinterest in using evidence to inform its policy positions.

But an article in The Australian said there was some evidence linking breast cancer with abortions in China, and that we shouldn’t ignore this evidence, unpalatable as it may be.

In this article for The Conversation, Bruce Neal, the Chair of the Australian Division of World Action on Salt and Health, breaks down the latest research findings on salt and health, and explains what policy makers need to know.

Data from this season’s flu season is alarming many, The Guardian said, but Croakey shared a post by infectious diseases researcher Heath Kelly from the Australian National University (originally published by The Conversation) explaining why these numbers could be misleading.

The Canberra Times reported on some interesting new Australian research showing the health and economic benefits of publicly funded bariatric surgery.

The effects of obesity are often far broader and reach further than many appreciate. This month’s Journal Watch by Dr Melissa Stoneham examined the stigma faced by overweight young people, with overweight teens more likely to be denied friendships from their peers of normal weight.

And Anne Cahill Lambert wrote a blog post for Croakey about inequity in the research sector, and why initiatives to increase the number of women in research are important.

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Other Croakey reading you might have missed

• Reflections of an economic migrant: one life should not be valued more than another’s
• Big Data: exciting – until it’s not big data
• NCDs: time for a policy push for Global Health’s poor cousin.